NVP Counselor
Date: 2005-12-27

Question:
I just discovered I'm 6 weeks pregnant with my 5th pregnancy. All previous pregnancies, I had severe Nausea and vomitting, requiring several hospitalizations. Phenegran, reglan, zofran, b6/antihistamines and other type medications never did anything for the nausea. I'm miserable and pretty much non functioning until about 17 weeks. I'm already feeling some nausea which is about a week earlier than previous pregnancies. Is there any hope there is anything new that might work. My doctor has mentioned prednisone, but I'm scared to death as I've had one child that passed away in infancy. If no other medication has ever worked, is there any reasoning that steroids might? thanks for the service and research you do. Nausea and vomitting in pregnacy is horrible and many who've never experienced can't imagine how dehabilitating it can be.

Answer:
You seem to have tried most of the medications listed on our treatment algorithm, with no success in your previous pregnancies, except for steroids (Prednisone). Treating the symptoms at the very onset is another strategy that you might consider. You are welcome to call the Motherisk NVP Helpline (1-800-436-8477) to discuss this further.

Sometimes women who do not respond to typical NVP/HG treatment might actually be H.Pylori positive (a stomach bacteria), causing severe symptoms that require completely different treatment.

As for the safety of steroids, they are not commonly used or recommended in the first trimester as they are associated with a small, but higher incidence of oral cleft. The occurrence of oral cleft in the general population is 1 in 1000. You may want to consult your local teratogen information service. To find one visit the OTIS website.